{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T11:38:36Z","timestamp":1784806716867,"version":"3.55.0"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECT<\/jats:title>\n                    <jats:p>Most of the craniometric relationships of the normal craniocervical junction (CCJ), especially those related to angular craniometry, are still poorly studied and based on measurements taken from simple plain radiographs. In this study, the authors performed a craniometric evaluation of the CCJ in a population without known CCJ anomalies. The purpose of the study was to evaluate the normal CCJ craniometry based on measurements obtained from CT scans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHOD<\/jats:title>\n                    <jats:p>The authors analyzed 100 consecutive CCJ CT scans obtained in adult patients who were admitted at their tertiary hospital for treatment of non-CCJ conditions between 2010 and 2012. A total of 17 craniometrical measurements were performed, including the relation of the odontoid with the cranial base, the atlantodental interval (ADI), the clivus length, the clivus-canal angle (CCA)\u2014the angle formed by the clivus and the upper cervical spine, and the basal angle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The mean age of the 100 patients was 50.6 years, and the group included 52 men (52%) and 48 women (48%). In 5 patients (5%), the tip of the odontoid process was more than 2 mm above the Chamberlain line, and in one of these 5 patients (1% of the study group). it was more than 5 mm above it. One patient had a Grabb-Oakes measurement above 9 mm (suggesting ventral cervicomedullary encroachment). The mean ADI value was 1.1 mm. The thickness of the external occipital protuberance ranged from 7.42 to 22.36 mm. The mean clivus length was 44.74 mm, the mean CCA was 153.68\u00b0 (range 132.32\u00b0\u2013173.95\u00b0), and the mean basal angle was 113.73\u00b0 (ranging from 97.06\u00b0\u2013133.26\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The data obtained in this study can be useful for evaluating anomalies of the CCJ in comparison with normal parameters, potentially improving the diagnostic criteria of these anomalies. When evaluating CCJ malformations, one should take into account the normal ranges based on CT scans, with more precise bone landmarks, instead of those obtained from simple plain radiographs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.1.focus14642","type":"journal-article","created":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T13:05:25Z","timestamp":1427893525000},"page":"E5","source":"Crossref","is-referenced-by-count":46,"title":["Computed tomography evaluation of the normal craniocervical junction craniometry in 100 asymptomatic patients"],"prefix":"10.3171","volume":"38","author":[{"given":"Ulysses C.","family":"Batista","sequence":"first","affiliation":[{"name":"Department of Neurology, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei F.","family":"Joaquim","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvens B.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger N.","family":"Mathias","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Ghizoni","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helder","family":"Tedeschi","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus14642","series-title":"Neurosurg Rev","first-page":"603","article-title":"Angular craniometry in craniocer-vical junction malformation","volume":"36","author":"Botelho","year":"2013"},{"key":"b2-focus14642","series-title":"Acta Ortop Bras","first-page":"136","article-title":"Tomographic study of the atlas concerning screw fixation on lateral mass","volume":"17","author":"Carvalho","year":"2009"},{"key":"b3-focus14642","series-title":"Yale J Biol Med","first-page":"487","article-title":"Basilar impression (platybasia). A bizarre developmental anomaly of the occipital bone and upper cervical spine with striking and misleading neurologic manifestations","volume":"11","author":"Chamberlain","year":"1939"},{"key":"b4-focus14642","series-title":"Turk Neurosurg","first-page":"416","article-title":"Morphological analysis and morphometry of the foramen magnum: an anatomical investigation","volume":"22","author":"Chethan","year":"2012"},{"key":"b5-focus14642","series-title":"Radiol Clin North Am","first-page":"155","article-title":"Cervicobasilar relationships","volume":"15","author":"Dolan","year":"1977"},{"key":"b6-focus14642","series-title":"Can J Neurol Sci","first-page":"452","article-title":"Posterior fossa measurements in patients with and without Chiari I malformation","volume":"38","author":"Dufton","year":"2011"},{"key":"b7-focus14642","series-title":"Spine J","article-title":"Factors determining cervical spine sagittal balance in asymptomatic adults: correlation with spinopelvic balance and thoracic inlet alignment","author":"Lee","year":"2013"},{"key":"b8-focus14642","series-title":"Neurol India","first-page":"235","article-title":"Basilar invagination, Chiari malformation, syringomyelia : a review","volume":"57","author":"Goel","year":"2009"},{"key":"b9-focus14642","series-title":"Neurosurgery","first-page":"520","article-title":"Ventral brain stem compression in pediatric and young adult patients with Chiari I malformations","volume":"44","author":"Grabb","year":"1999"},{"key":"b10-focus14642","series-title":"J Neurosurg","first-page":"942","article-title":"Normalization of hindbrain morphology after decompression of Chiari malformation Type I","volume":"117","author":"Heiss","year":"2012"},{"key":"b11-focus14642","series-title":"Surg Neurol Int","first-page":"30","article-title":"Deformative stress associated with an abnormal clivo-axial angle: a finite element analysis","volume":"1","author":"Henderson","year":"2010"},{"key":"b12-focus14642","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"945","article-title":"Measurement of the atlanto-dental interval in the adult","volume":"84","author":"Hinck","year":"1960"},{"key":"b13-focus14642","series-title":"Acta Neurochir (Wien)","first-page":"165","article-title":"Morphometric measurements of the cranium in patients with Chiari type I malformation and comparison with the normal population","volume":"144","author":"Karag\u00f6z","year":"2002"},{"key":"b14-focus14642","series-title":"AJNR Am J Neuroradiol","first-page":"89","article-title":"Evaluation of platybasia with MR imaging","volume":"26","author":"Koenigsberg","year":"2005"},{"key":"b15-focus14642","series-title":"AJR Am J Roentgenol","first-page":"W421","article-title":"Craniometric measurements in the assessment of craniovertebral settling: are they still relevant in the age of cross-sectional imaging?","volume":"196","author":"Kwong","year":"2011"},{"key":"b16-focus14642","series-title":"Iran J Radiol","first-page":"71","article-title":"Morphometric analysis of the internal auditory canal by computed tomography imaging","volume":"9","author":"Marques","year":"2012"},{"key":"b17-focus14642","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"23","article-title":"Occipitalization of the atlas","volume":"70","author":"McRae","year":"1953"},{"key":"b18-focus14642","series-title":"Neurosurgery","first-page":"707","article-title":"Implications of spinopelvic alignment for the spine surgeon","volume":"70","author":"Mehta","year":"2012"},{"key":"b19-focus14642","series-title":"AJNR Am J Neuroradiol","first-page":"1819","article-title":"Reassessment of the craniocervical junction: normal values on CT","volume":"28","author":"Rojas","year":"2007"},{"key":"b20-focus14642","series-title":"Clin Ter","first-page":"479","article-title":"Occipital condyle morphometry and incidence of condylus tertius: phylogenetic and clinical significance","volume":"163","author":"Saralaya","year":"2012"},{"issue":"3 Suppl","key":"b21-focus14642","series-title":"Neurosurgery","first-page":"39","article-title":"Basilar invagination","volume":"66","author":"Smith","year":"2010"},{"key":"b22-focus14642","series-title":"Radiographics","first-page":"255","article-title":"Craniovertebral junction: normal anatomy, craniometry, and congenital anomalies","volume":"14","author":"Smoker","year":"1994"},{"key":"b23-focus14642","series-title":"Spine (Phila Pa 1976)","first-page":"1121","article-title":"Craniopelvic alignment in elderly asymptomatic individuals: analysis of 671 cranial centers of gravity","volume":"39","author":"Yoshida","year":"2014"},{"key":"b1-focus14642","series-title":"Neurosurg Rev","first-page":"603","article-title":"Angular craniometry in craniocer-vical junction malformation","volume":"36","author":"Botelho","year":"2013"},{"key":"b2-focus14642","series-title":"Acta Ortop 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A bizarre developmental anomaly of the occipital bone and upper cervical spine with striking and misleading neurologic manifestations","volume":"11","author":"Chamberlain","year":"1939"},{"key":"b4-focus14642","series-title":"Turk Neurosurg","first-page":"416","article-title":"Morphological analysis and morphometry of the foramen magnum: an anatomical investigation","volume":"22","author":"Chethan","year":"2012"},{"key":"b5-focus14642","series-title":"Radiol Clin North Am","first-page":"155","article-title":"Cervicobasilar relationships","volume":"15","author":"Dolan","year":"1977"},{"key":"b6-focus14642","series-title":"Can J Neurol Sci","first-page":"452","article-title":"Posterior fossa measurements in patients with and without Chiari I malformation","volume":"38","author":"Dufton","year":"2011"},{"key":"b7-focus14642","series-title":"Spine J","article-title":"Factors determining cervical spine sagittal balance in asymptomatic adults: correlation with spinopelvic balance and thoracic inlet alignment","author":"Lee","year":"2013"},{"key":"b8-focus14642","series-title":"Neurol India","first-page":"235","article-title":"Basilar invagination, Chiari malformation, syringomyelia : a review","volume":"57","author":"Goel","year":"2009"},{"key":"b9-focus14642","series-title":"Neurosurgery","first-page":"520","article-title":"Ventral brain stem compression in pediatric and young adult patients with Chiari I malformations","volume":"44","author":"Grabb","year":"1999"},{"key":"b10-focus14642","series-title":"J Neurosurg","first-page":"942","article-title":"Normalization of hindbrain morphology after decompression of Chiari malformation Type I","volume":"117","author":"Heiss","year":"2012"},{"key":"b11-focus14642","series-title":"Surg Neurol Int","first-page":"30","article-title":"Deformative stress associated with an abnormal clivo-axial angle: a finite element analysis","volume":"1","author":"Henderson","year":"2010"},{"key":"b12-focus14642","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"945","article-title":"Measurement of the atlanto-dental interval in the adult","volume":"84","author":"Hinck","year":"1960"},{"key":"b13-focus14642","series-title":"Acta Neurochir (Wien)","first-page":"165","article-title":"Morphometric measurements of the cranium in patients with Chiari type I malformation and comparison with the normal population","volume":"144","author":"Karag\u00f6z","year":"2002"},{"key":"b14-focus14642","series-title":"AJNR Am J Neuroradiol","first-page":"89","article-title":"Evaluation of platybasia with MR imaging","volume":"26","author":"Koenigsberg","year":"2005"},{"key":"b15-focus14642","series-title":"AJR Am J Roentgenol","first-page":"W421","article-title":"Craniometric measurements in the assessment of craniovertebral settling: are they still relevant in the age of cross-sectional imaging?","volume":"196","author":"Kwong","year":"2011"},{"key":"b16-focus14642","series-title":"Iran J Radiol","first-page":"71","article-title":"Morphometric analysis of the internal auditory canal by computed tomography imaging","volume":"9","author":"Marques","year":"2012"},{"key":"b17-focus14642","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"23","article-title":"Occipitalization of the atlas","volume":"70","author":"McRae","year":"1953"},{"key":"b18-focus14642","series-title":"Neurosurgery","first-page":"707","article-title":"Implications of spinopelvic alignment for the spine surgeon","volume":"70","author":"Mehta","year":"2012"},{"key":"b19-focus14642","series-title":"AJNR Am J Neuroradiol","first-page":"1819","article-title":"Reassessment of the craniocervical junction: normal values on CT","volume":"28","author":"Rojas","year":"2007"},{"key":"b20-focus14642","series-title":"Clin Ter","first-page":"479","article-title":"Occipital condyle morphometry and incidence of condylus tertius: phylogenetic and clinical 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